I TAX Change of Address Form - Alabama Department of Revenue

ALABAMA DEPARTMENT OF REVENUE

6/2017

INDIVIDUAL INCOME TAX

Change of Address Form

Please complete all fields and return the completed form to the mailing address shown below. Forms submitted without a Social Security Number will not be processed.

Date: _______________________________________________________________________________________________________ Name: ______________________________________________________________________________________________________ Spouse's Name: ______________________________________________________________________________________________ Primary last four digits of Social Security Number: ____________________________________________________________________ Spouse's last four digits of Social Security Number: ___________________________________________________________________ Amount of current year Alabama refund or amount owed to Alabama: $___________________________________________________ Daytime Telephone Number: (________)___________________________________________________________________________

AREA CODE

Former Mailing Address: ________________________________________________________________________________________

ADDRESS

________________________________________________________________________________________

CITY

STATE

ZIP CODE

Date New Mailing Address in Effect: _______________________________________________________________________________

MONTH

DAY

YEAR

New Mailing Address: __________________________________________________________________________________________

ADDRESS

__________________________________________________________________________________________

CITY

STATE

ZIP CODE

___________________________________________________

SIGNATURE

_____________________________________________________

SPOUSE'S SIGNATURE (IF JOINT RETURN, BOTH MUST SIGN)

Mail to: Alabama Department of Revenue, I/C Tax Division POBox 327410

Montgomery, AL 36132-7410

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